Thyroid UK
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Hi I have just joined, I have been getting some symptoms which I cannot make sense of and have decided to seek advice here. I have pains in my bones, joint stiffness, ears ringing, dry skin, constipation mixed with diarrhoea (GP given me a diagnosis of irritable bowel syndrome), feeling cold, weight gain. I take 175mcg Levo and I was diagnosed in 2010. I also have iron anaemia, vit D deficiency, folate deficiency and low B12. Am I right to assume I have Hashimotos?

Any advice welcome!

TSH 4.69 (0.2 - 4.2)

FREE T4 14.7 (12 - 22)

FREE T3 3.5 (3.1 - 6.8)



4 Replies

Yes you have Hashi's which has most likely caused absorption problems which is why you have all those nutrient deficiencies.

SlowDragon has information and links about dealing with gut and absorption problems.


People feel usually better when their tsh is 1.0 or less, you should ask for a dose increase


Yes, your antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

About 90% of all hypothyroidism in Uk is due to Hashimoto's

Absolutely essential to test vitamin D, folate, ferritin and B12. And supplement adequately to correct

Always get actual results and ranges. Post results if you have them, members can advise

Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels

Low vitamin levels affect Thyroid hormone working

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

But don't be surprised that GP or endo never mention gut, gluten or low vitamins. Hashimoto's is very poorly understood

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

Ask GP for coeliac blood test first. They should have tested for this much earlier than this

Persistent low vitamins with supplements suggests coeliac disease or gluten intolerance

Perhaps put your vitamin results and what supplements you currently take on new post. More members can advise

Your results show you are very under medicated. Dose should be increased by 25mcgs and retested in 6-8 weeks

Typical post with Low vitamins due to under medication and detailed supplements advice on how to improve

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.

Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor

please email Dionne:

Also request list of recommended thyroid specialists

Professor Toft recent article saying, T3 may be necessary for many

Note in the article how high Levothyroxine dose use to be in the past

With Hashimoto's we need to get vitamins optimal and strictly gluten free diet can help gut heal

Dose of Levothyroxine should be increased enough for TSH to be around one and FT4 towards top of range

If FT3 remains low, then like many with Hashimoto's, you may need small dose of T3

But other steps must be taken first


High probability that you not only have hashi's but also have PA


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